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Description
Background: Heart failure is the leading cause of hospitalization in older adults and has the highest 30-day readmission rate of all diagnoses. An estimated 30 to 60 percent of older adults lose some degree of physical function in the course of an acute hospital stay. Few studies have addressed the role of posture and mobility in contributing to, or improving, physical function in older hospitalized adults. No study to date that we are aware of has addressed this in the older heart failure population.
Purpose: To investigate the predictive value of mobility during a hospital stay and patterns of mobility during the month following discharge on hospital readmission and 30-day changes in functional status in older heart failure patients.
Methods: This was a prospective observational study of 21 older (ages 60+) patients admitted with a primary diagnosis of heart failure. Patients wore two inclinometric accelerometers (rib area and thigh) to record posture and an accelerometer placed at the ankle to record ambulatory activity. Patients wore all sensors continuously during hospitalization and the ankle accelerometer for 30 days after hospital discharge. Function was assessed in all patients the day after hospital discharge and again at 30 days post-discharge.
Results: Five patients (23.8%) were readmitted within the 30 day post-discharge period. None of the hospital or post-discharge mobility measures were associated with readmission after adjustment for covariates. Higher percent lying time in the hospital was associated with slower Timed Up and Go (TUG) time (b = .08, p = .01) and poorer hand grip strength (b = -13.94, p = .02) at 30 days post-discharge. Higher daily stepping activity during the 30 day post-discharge period was marginally associated with improvements in SPPB scores at 30 days (b = <.001, p = .06).
Conclusion: For older heart failure patients, increased time lying while hospitalized is associated with slower walking time and poor hand grip strength 30 days after discharge. Higher daily stepping after discharge may be associated with improvements in physical function at 30 days.
Purpose: To investigate the predictive value of mobility during a hospital stay and patterns of mobility during the month following discharge on hospital readmission and 30-day changes in functional status in older heart failure patients.
Methods: This was a prospective observational study of 21 older (ages 60+) patients admitted with a primary diagnosis of heart failure. Patients wore two inclinometric accelerometers (rib area and thigh) to record posture and an accelerometer placed at the ankle to record ambulatory activity. Patients wore all sensors continuously during hospitalization and the ankle accelerometer for 30 days after hospital discharge. Function was assessed in all patients the day after hospital discharge and again at 30 days post-discharge.
Results: Five patients (23.8%) were readmitted within the 30 day post-discharge period. None of the hospital or post-discharge mobility measures were associated with readmission after adjustment for covariates. Higher percent lying time in the hospital was associated with slower Timed Up and Go (TUG) time (b = .08, p = .01) and poorer hand grip strength (b = -13.94, p = .02) at 30 days post-discharge. Higher daily stepping activity during the 30 day post-discharge period was marginally associated with improvements in SPPB scores at 30 days (b = <.001, p = .06).
Conclusion: For older heart failure patients, increased time lying while hospitalized is associated with slower walking time and poor hand grip strength 30 days after discharge. Higher daily stepping after discharge may be associated with improvements in physical function at 30 days.
ContributorsFloegel, Theresa A (Author) / Buman, Matthew P (Thesis advisor) / Hooker, Steven (Committee member) / Dickinson, Jared (Committee member) / DerAnanian, Cheryl (Committee member) / McCarthy, Marianne (Committee member) / Arizona State University (Publisher)
Created2015
Description
Obesity impairs skeletal muscle maintenance and regeneration, a condition that can progressively lead to muscle loss, but the mechanisms behind it are unknown. Muscle is primarily composed of multinucleated cells called myotubes which are derived by the fusion of mononucleated myocytes. A key mediator in this process is the cellular fusion protein syncytin-1. This led to the hypothesis that syncytin-1 could be decreased in the muscle of obese/insulin resistant individuals. In contrast, it was found that obese/insulin resistant subjects had higher syncytin-1 expression in the muscle compared to that of the lean subjects. Across the subjects, syncytin-1 correlated significantly with body mass index, percent body fat, blood glucose and HbA1c levels, insulin sensitivity and muscle protein fractional synthesis rate. The concentrations of specific plasma fatty acids, such as the saturated fatty acid (palmitate) and monounsaturated fatty acid (oleate) are known to be altered in obese/insulin resistant humans, and also to influence the protein synthesis in muscle. Therefore, it was evaluated that the effects of palmitate and oleate on syncytin-1 expression, as well as 4E-BP1 phosphorylation, a key mechanism regulating muscle protein synthesis in insulin stimulated C2C12 myotubes. The results showed that treatment with 20 nM insulin, 300 µM oleate, 300 µM oleate +20 nM insulin and 300 µM palmitate + 300 µM oleate elevated 4E-BP1 phosphorylation. At the same time, 20 nM insulin, 300 µM palmitate, 300 µM oleate + 20 nM insulin and 300 µM palmitate + 300 µM oleate elevated syncytin-1 expression. Insulin stimulated muscle syncytin-1 expression and 4E-BP1 phosphorylation, and this effect was comparable to that observed in the presence of oleate alone. However, the presence of palmitate + oleate diminished the stimulatory effect of insulin on muscle syncytin-1 expression and 4E-BP1 phosphorylation. These findings indicate oleate but not palmitate increased total 4E-BP1 phosphorylation regardless of insulin and the presence of palmitate in insulin mediated C2C12 cells. The presence of palmitate inhibited the upregulation of total 4EB-P1 phosphorylation. Palmitate but not oleate increased syncytin-1 expression in insulin mediated C2C12 myotubes. It is possible that chronic hyperinsulinemia in obesity and/or elevated levels of fatty acids such as palmitate in plasma could have contributed to syncytin-1 overexpression and decreased muscle protein fractional synthesis rate in obese/insulin resistant human muscle.
ContributorsRavichandran, Jayachandran (Author) / Katsanos, Christos (Thesis advisor) / Coletta, Dawn (Committee member) / Dickinson, Jared (Committee member) / Arizona State University (Publisher)
Created2017
Description
For as long as humans have been working, they have been looking for ways to get that work done better, faster, and more efficient. Over the course of human history, mankind has created innumerable spectacular inventions, all with the goal of making the economy and daily life more efficient. Today, innovations and technological advancements are happening at a pace like never seen before, and technology like automation and artificial intelligence are poised to once again fundamentally alter the way people live and work in society. Whether society is prepared or not, robots are coming to replace human labor, and they are coming fast. In many areas artificial intelligence has disrupted entire industries of the economy. As people continue to make advancements in artificial intelligence, more industries will be disturbed, more jobs will be lost, and entirely new industries and professions will be created in their wake. The future of the economy and society will be determined by how humans adapt to the rapid innovations that are taking place every single day. In this paper I will examine the extent to which automation will take the place of human labor in the future, project the potential effect of automation to future unemployment, and what individuals and society will need to do to adapt to keep pace with rapidly advancing technology. I will also look at the history of automation in the economy. For centuries humans have been advancing technology to make their everyday work more productive and efficient, and for centuries this has forced humans to adapt to the modern technology through things like training and education. The thesis will additionally examine the ways in which the U.S. education system will have to adapt to meet the demands of the advancing economy, and how job retraining programs must be modernized to prepare workers for the changing economy.
ContributorsCunningham, Reed P. (Author) / DeSerpa, Allan (Thesis director) / Haglin, Brett (Committee member) / School of International Letters and Cultures (Contributor) / Department of Finance (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Nuclear weapons possess enormous potential to inflict damage on our world. The majority of countries in the world denounce the proliferation of these weapons, but a minority of countries have a desire to proliferate. This essay analyzes the impact of regime type and alliance strength to a nuclear state on protégé proliferation decisions. Prior research focuses on single factors in proliferation decisions and fails to take in to account the multi-faceted factors that influence the international system that states operate in. The analysis finds that regime type gives an indication about a state’s likelihood to proliferate, but does not explain proliferation choices comprehensively. Alliance strength plays a large role in a state’s security calculations and must be analyzed in conjunction to regime type to understand proliferation decisions.
ContributorsHsu, Kai Nalu (Author) / Wright, Thorin (Thesis director) / Thies, Cameron (Committee member) / W.P. Carey School of Business (Contributor) / Department of Finance (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
#VanLife is a long-time, up and coming lifestyle movement on social media centered around the process of leaving the traditional nine-to-five work week for a life on the road in a camper van. While the ‘hippie-esque’ vagabond lifestyle has its humble roots long before the turn of the century, the inception of social media platforms such as Instagram and Pinterest have fueled the more recent popularization of a full-time life on the road. #VanLifers often freelance on the road, work part time jobs, or gain sponsorships to help fund their traveling and humble lifestyle.
As the #VanLife craze continues to grow, new businesses are finding ways to meet the demand in the market. For #Vanlifers who own and operate their own camper vans, specialized companies like GoWesty, Vanagain, and Boxeer offer a full range of parts, upgrades, and custom mechanical and systems conversion kits to keep these vans on the road as OE manufacturers discontinue production on these parts. For those who have an itch to try out the #VanLife for a shorter period and without the financial commitment, companies like Roamerica, TontoTrails, and adventureRIGS offer nightly and weekly rental opportunities on fully-outfitted campervans ready to hit the road.
For my Honors Project I wrote a complete analysis on the history, development, and modernization of the #VanLife movement. With plans to take to the road for an extended period of time after graduation, I also developed a complete financial plan for a one-year #VanLife experience. The financial plan includes a comprehensive set of budgets that scrutinize the start-up an operational costs of the #VanLife and associated travel.
As the #VanLife craze continues to grow, new businesses are finding ways to meet the demand in the market. For #Vanlifers who own and operate their own camper vans, specialized companies like GoWesty, Vanagain, and Boxeer offer a full range of parts, upgrades, and custom mechanical and systems conversion kits to keep these vans on the road as OE manufacturers discontinue production on these parts. For those who have an itch to try out the #VanLife for a shorter period and without the financial commitment, companies like Roamerica, TontoTrails, and adventureRIGS offer nightly and weekly rental opportunities on fully-outfitted campervans ready to hit the road.
For my Honors Project I wrote a complete analysis on the history, development, and modernization of the #VanLife movement. With plans to take to the road for an extended period of time after graduation, I also developed a complete financial plan for a one-year #VanLife experience. The financial plan includes a comprehensive set of budgets that scrutinize the start-up an operational costs of the #VanLife and associated travel.
ContributorsRischitelli, Noah Gary (Author) / Garverick, Michael (Thesis director) / Dawson, Gregory (Committee member) / WPC Graduate Programs (Contributor) / School of Accountancy (Contributor) / Department of Finance (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
This thesis project was conducted to create a practical tool to help micro and small local food enterprises identify potential strategies and sources of finance. Currently, many of these enterprises are unable to obtain the financial capital needed to start-up or maintain operations.
Sources and strategies of finance studied and ultimately included in the tool were Loans, Equity, Membership, Crowdfunding, and Grants. The tool designed was a matrix that takes into account various criteria of the business (e.g. business lifecycle, organizational structure, business performance) and generates a financial plan based on these criteria and how they align with the selected business strategies. After strategies are found, stakeholders can search through an institutional database created in conjunction with the matrix tool to find possible institutional providers of financing that relate to the strategy or strategies found.
The tool has shown promise in identifying sources of finance for micro and small local food enterprises in practical use with hypothetical business cases, however further practical use is necessary to provide further input and revise the tool as needed. Ultimately, the tool will likely become fully user-friendly and stakeholders will not need the assistance of another expert helping them to use it. Finally, despite the promise of the tool itself, the fundamental and underlying problem that many of these businesses face (lack of infrastructure and knowledge) still exists, and while this tool can also help capacity-building efforts towards both those seeking and those providing finance, an institutional attitude adjustment towards social and alternative enterprises is necessary in order to further simplify the process of obtaining finance.
Sources and strategies of finance studied and ultimately included in the tool were Loans, Equity, Membership, Crowdfunding, and Grants. The tool designed was a matrix that takes into account various criteria of the business (e.g. business lifecycle, organizational structure, business performance) and generates a financial plan based on these criteria and how they align with the selected business strategies. After strategies are found, stakeholders can search through an institutional database created in conjunction with the matrix tool to find possible institutional providers of financing that relate to the strategy or strategies found.
The tool has shown promise in identifying sources of finance for micro and small local food enterprises in practical use with hypothetical business cases, however further practical use is necessary to provide further input and revise the tool as needed. Ultimately, the tool will likely become fully user-friendly and stakeholders will not need the assistance of another expert helping them to use it. Finally, despite the promise of the tool itself, the fundamental and underlying problem that many of these businesses face (lack of infrastructure and knowledge) still exists, and while this tool can also help capacity-building efforts towards both those seeking and those providing finance, an institutional attitude adjustment towards social and alternative enterprises is necessary in order to further simplify the process of obtaining finance.
ContributorsDwyer, Robert Francis (Author) / Wiek, Arnim (Thesis director) / Forrest, Nigel (Committee member) / Department of Finance (Contributor) / Department of Information Systems (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
This paper will focus on the changes in China's OFDI while also explaining its growth. However, another primary focus will be comparing the relationships between China, Hong Kong, and Africa. This paper will show the correlating changes between the three regions and explain the distribution of China's investments. One argument is that Hong Kong may play a large role in facilitating Chinese investment into Africa, which if not disaggregated, could lead to inaccurate numbers of China's FDI into Africa. The purpose of this paper is to investigate the importance of China's relationship with Hong Kong and Africa. In 2012, Garth Shelton argued that Hong Kong was an important gateway in South Africa's trade with China. Since then, many others have made similar claims in support of Hong Kong's bigger role. However, due to the difficulty of finding specific data for each region, these analyses are incomplete and fail to clearly substantiate their theory. I will try to find a correlation by gathering my own data, tables, and through different interviews.
ContributorsSon, James (Author) / Simonson, Mark (Thesis director) / Iheduru, Okechukwu (Committee member) / Economics Program in CLAS (Contributor) / Department of Finance (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
This thesis examines the impact of price changes of select microprocessors on the market share and 5-year gross profit net present values of Company X in the networking market through a multi-step analysis. The networking market includes segments including media processing, cloud services, security, routers & switches, and access points. For this thesis our team focused on the routers & switches, as well as the security segments. Company X wants to capitalize on the expected growth of the networking market as it transitions to its fifth generation (henceforth referred to as 5G) by positioning itself favorably in its customers eyes through high quality products offered at competitive prices. Our team performed a quantitative analysis of benchmark data to measure the performances of Company X's products against those of its competitors. We collected this data from third party computer reviewers, as well as the published reports of Company X and its competitors. Through the use of a preference matrix, we then normalized this performance data to adjust for different scales. In order to provide a well-rounded analysis, we adjusted these normalized performances for power consumption (using thermal design power as a proxy) as well as price. We believe these adjusted performances are more valuable than raw benchmark data, as they appeal to the demands of price-sensitive customers. Based on these comparisons, our team was able to assess price changes for their market and discounted financial impact on Company X. Our findings challenge the current pricing of one of the two products being analyzed and suggests a 9% decrease in the price of said product. This recommendation most effectively positions Company X for the development of 5G by offering the best balance of market share and NPV.
ContributorsArias, Stephen (Co-author) / Masson, Taylor (Co-author) / McCall, Kyle (Co-author) / Dimitroff, Alex (Co-author) / Hardy, Sebastian (Co-author) / Simonson, Mark (Thesis director) / Haller, Marcie (Committee member) / School of Accountancy (Contributor) / Department of Finance (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
While developing and maintaining a connection between a brand and a customer has always been in the forefront of marketers' agendas, it has become an even more pressing goal as digital trends in marketing surface. Although the idea of using rewards to foster consumer-brand connection has been around for decades, marketers are still struggling to optimize the benefits. How can marketers use rewards to better connect with their customers? Are there certain types of rewards that are more effective than others? Are certain rewards more effective when being implemented under brands of a certain personality type? In a society that values connection and relationship, marketers cannot lose their ability to appreciate customers under digital constraints and to marketplace competition. Through a field study and scenario-based experiment, we explore how and why low conditional vs. high conditional rewards influence consumer-brand connection and the role brand personality plays.
ContributorsBauer, Madelaine Anne (Co-author) / Bryant, Kelly (Co-author) / Lisjak, Monika (Thesis director) / Samper, Adriana (Committee member) / Department of Finance (Contributor) / W.P. Carey School of Business (Contributor) / Department of Marketing (Contributor) / Sandra Day O'Connor College of Law (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
DescriptionI made a full business plan and pitch to investors for a company I plan on starting next semester.
ContributorsOramas, Michael (Author) / Trujillo, Rhett (Thesis director) / Naumann, Gary (Committee member) / Department of Finance (Contributor) / Department of Management and Entrepreneurship (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12